title: Neuro-Behçet disease presenting with acute psychosis in an adolescent.
abstract: Behçet disease is a systemic vasculitis of unknown etiology that can affect the neurologic system. Neuro-Behçet disease is not well defined in children and adolescents, and the diagnosis is difficult to make in this population as they often present with insufficient symptoms to meet diagnostic criteria. Psychiatric symptoms as the initial manifestation of neuro-Behçet disease has rarely been reported. We describe a 17-year-old boy who presented with acute psychosis and was subsequently diagnosed with neuro-Behçet disease. A rare combination of both cerebral venous thrombosis and parenchymal central nervous system involvement was identified by neuroimaging. Although treatment guidelines for neuro-Behçet disease are limited, the patient made demonstrative clinical and radiographic improvement with a combination of corticosteroids, anticoagulation, and immunosuppressants, including a tumor necrosis factor-α (TNFα) blocking agent.
authors.affiliation: Montefiore Medical Center and Jacobi Medical Center, Department of Neurology, Bronx, NY, USA puj.patel@gmail.com.
authors.forename: Puja
authors.initials: P
authors.lastname: Patel
authors.affiliation: Albert Einstein College of Medicine and Jacobi Medical Center, Department of Neurology, Bronx, NY, USA.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Steinschneider
authors.affiliation: The Children's Hospital at Montefiore and Jacobi Medical Center, Department of Rheumatology, Bronx, NY, USA.
authors.forename: Alexis
authors.initials: A
authors.lastname: Boneparth
authors.affiliation: Jacobi Medical Center, Department of Radiology, Bronx, NY, USA.
authors.forename: George
authors.initials: G
authors.lastname: Lantos
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
keywords: acute psychosis; anti-tumor necrosis factor-α; cerebral venous thrombosis; childhood; neuro-Behçet disease